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DSS enrolls 20 percent of Medicaid expansion population in three months

Lee Strubinger

Just over 10,000 South Dakotans are enrolled through Medicaid expansion.

That’s less than 20 percent of the amount of people the state expects to enroll, which is drawing ire from some state lawmakers.

The state Department of Social Services anticipates 57,000 individuals to enroll in Medicaid expansion. The state hired 68 new staff to handle the increased workload.

DSS officials said Monday it’s taking an average of 24 days to process Medicaid applications for these new individuals. The department is seeing steady enrollment growth and staff is working overtime to process those applications.

During an interim budgetary hearing, some lawmakers expressed frustration with the Medicaid expansion rollout.

Because DSS was funded to handle 57,000 new individuals, appropriations chair Representative Mike Derby expects that money to revert to the general fund at the end of the fiscal year.

“I’m just having a hard time reconciling why we’re having overtime. Why we’re not getting things done quicker when we’re not even close to what the department thought might happen," Derby said.

In addition to rolling out Medicaid expansion, the DSS was clearing is Medicaid rolls post-pandemic. The public health emergency prohibited the state from scrubbing is Medicaid rolls. South Dakota was one of the first to declare the public health emergency over.

DSS Secretary Matt Althoff said the enrollment will take time.

“Our specialists are getting more and more proficient. But when you start from ground zero—and oh by the way—as these new hires did, these 68 new hires did, we’re in the middle of unwinding and then we’re running into the middle of expansion," Althoff said. "We were not on the A game as a department because our staff was new to it and didn’t have the seasoned experience.”

Althoff expects the state will eventually enroll up to 57,000 individuals in two years. He said that’s based on how other states have implemented Medicaid expansion.

Voters overwhelmingly approved Medicaid expansion in the last election.

The state appropriated over $65 million in general funds to Medicaid. In turn, feds are putting in over $485 million to the program. That’s a 7.5 to one ratio.

Lee Strubinger is SDPB’s Rapid City-based news and political reporter. A former reporter for Fort Lupton Press (CO) and Colorado Public Radio, Lee holds a master’s in public affairs reporting from the University of Illinois-Springfield.